Pregnancy, vaccination and Whooping Cough

Not that long ago vaccinations and pregnancy were mutually exclusive. Whilst the majority of vaccinations are still not recommended in pregnancy, there are a couple which are worthwhile getting.

Influenza vaccination - Seasonal influenza vaccination was the first vaccination routinely recommended for pregnant women. Pregnant women are at increased risk of morbidity (getting sick) and mortality (dying) from influenza. Timing of vaccination is dependent on the time of the year, vaccine availability and influenza seasonality. Vaccination can take place at any gestation or during breastfeeding. There are no effects on the developing baby although a lot of women feel more comfortable until they are through the first trimester of pregnancy before getting the vaccination.

Whooping cough - Until recently, whooping cough (Pertussis) vaccination was NOT recommended during pregnancy. The standard was for women to be vaccinated AFTER their baby was born. However, Pertussis vaccination DURING pregnancy has now evolved to the point where it has recently become recommended that ALL women in the third trimester of pregnancy (around 28-32 weeks gestation is ideal) be vaccinated, even when pregnancies are closely spaced (<2 years). Vaccination can be given at any time during the third trimester up until birth. Maternal antibodies (which fight infection) are transmitted across the placenta to the baby to help protect it after birth. Previously, it was recommended that if a booster had been given to the mother within 5 years then there would be ample protection. However, it is now known that antibody levels in the mother decrease rapidly over time. The latest update to the vaccination schedule to incorporate these changes occured just last month.

Those of you in Australia will realise that the most recent media spotlight on Pertussis occured as a result of the very sad death of a baby in Western Australia. It's great that the media have increased awareness of this potentially preventable disease but yet again, in some quarters, the burden of responsibility seems to fall disproportionately onto the pregnant woman herself. Equal prominence in protecting the unborn baby from Pertussis should be given to vaccinating other adult household members, grandparents and carers of infants under 12 months of age.